Individual
DR. TONY TULLOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 KINGSLEY AVE, ORANGE PARK, FL 32073-5148
(904) 276-8517
(904) 276-8611
Mailing address
7111 FAIRWAY DR, SUITE 400, PALM BEACH GARDENS, FL 33418-4204
(561) 712-6265
(561) 712-7349
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
ME43280
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME0043280
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042304100
—
FL
01
—
P00314800
RR MEDICARE
FL
01
—
P220028013
RR MEDICARE
FL
Enumeration date
01/10/2006
Last updated
02/22/2010
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